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Hairdressing Consultation -Form Fill

Q1

Select a service
Q2

First Name

Full Name
Q3

Last Name

Full Name
Q4

Email
Q5

Phone Number

Phone Number
Q6

Street Address

Address
Q7

Street Address Line 2

Address
Q8

City

Address
Q9

State / Province

Address
Q10

Postal / Zip Code

Address
Q11

Are you pregnant? (Women)
Q12

Preferred Stylist
Q13

Desired Style
Q14

Please upload a photo of your current hair
Q15

Please upload the hair style that you want
Q16

What shampoo and conditioner are you using?
Q17

Type of Hair
Q18

Current length of Hair
Q19

Hair Condition
Q20

Scalp condition
Q21

How often do you go to salon?
Q22

When is the last time you visited a salon?
Q23

How often do you change the style of your hair?
Q24

Have you used a permanent color or semi-permanent clor before?
Q25

Do you wear a wig?
Q26

Do you have any synthetic hair?
Q27

Where did you hear about this salon?
Q28

Any special instructions?
Q29

Date Signed
Q30

Client's Signature